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Expertise in Indiana Health

What is neonatal abstinence syndrome?

Neonatal abstinence syndrome occurs when a fetus is exposed to opioids in utero and develops a tolerance for opioids. After the baby is born, a cycle of withdrawal begins with symptoms of mostly agitation, crying and irritability; sometimes diarrhea, difficulty feeding or even seizures are also part of symptoms. Limited data is available on the developmental outcomes of babies who have been exposed to opioids.


To treat a baby with neonatal abstinence syndrome, physicians give him or her a score to assess the level of symptoms and withdrawal, and then doctors adjust the amount of opioids given to them and slowly ween them off the medication. The amount of time the baby is in the neonatal intensive care unit varies, but typically, this process takes two to four weeks.


Neonatal abstinence syndrome is becoming more common in Indiana. In 2014, more than 500 babies were born with neonatal abstinence syndrome in Indiana. Neonatologists are seeing an increase in babies born with NAS every year.


Providing support to new moms after they leave the hospital with a new baby who has had neonatal abstinence syndrome is challenging. These women usually need to find new caregivers depending on their health needs, and many treatment programs for substance addictions do not accommodate a mother and baby pair. It can also be difficult for mothers to focus on their own recovery process while learning to care for a newborn with neonatal abstinence syndrome.

CARE Plus ProgramCARE Plus Attachment Training

Community health workers participating in the CARE Plus program work to build relationships with mothers and caregivers in hopes of helping them navigate some of these challenges and provide them with the resources they need—whether it’s health care, housing, food, or other social services, as well as helping new mothers find treatment and therapy for opioid dependence.